Female ICS-PFS Nomogram & PIP1 Predictor BETA

Evidence-Based Decision Support for Female Bladder Outlet Obstruction & Detrusor Contractility (Solomon-Greenwell)

About the Female BOO Nomogram

This diagnostic tool applies the validated Solomon-Greenwell criteria for identifying female Bladder Outlet Obstruction (fBOO).

The female BOO index is calculated as fBOOi = PdetQmax - 2.2 × Qmax. A decision boundary threshold of fBOOi > 5.0 (PdetQmax = 2.2 × Qmax + 5) corresponds to a 50% probability of obstruction (Sensitivity 0.86, Specificity 0.93).

Recent videourodynamic studies indicate that fBOO is present in 22.8% of women presenting with refractory LUTS, with anatomical pathology (62%) and functional non-relaxing sphincter (38%) being the primary causes.

Data Input

Enter female urodynamic data. PIP1 (PIP1 = PdetQmax + Qmax) and fBOOi (fBOOi = PdetQmax - 2.2 × Qmax) are calculated automatically.

Qmax (mL/s)

PdetQmax (cmH2O)

History of Mid-Urethral Sling (TVT/TOT)

Post-MUS Risk Sub-analysis Parameters (Bass, Christie & Zimmern)

Patient Age (years)

BMI (kg/m²)

Voiding Efficiency Parameters (Optional)

Voided Volume - Vvoid (mL)

Post-Void Residual - PVR (mL)

Calculated / Direct Index Input (Optional)

PIP1 (Female Contractility Index)

Reference Values & Criteria

WOMEN (Solomon–Greenwell / EAU Criteria):
• fBOOi Formula: PdetQmax - (2.2 * Qmax)
• fBOOi < 0: Unobstructed (< 10% BOO probability)
• fBOOi 0 – 5: Equivocal / Low Risk (10%–50% probability)
• fBOOi > 5: Likely Obstructed (50% decision boundary threshold)
• fBOOi > 18: Severe BOO / Almost Certain (> 90% probability)
• PIP1: PdetQmax + Qmax | < 30 cmH2O: Weak contractility | 30–150 cmH2O: Normal range

Primary Reference: Solomon E, Greenwell TJ et al. Neurourol Urodyn 2018;37(1):368-378.

A ICS-PFS plot nomogram for female patients (Solomon-Greenwell)

Solomon-Greenwell Nomogram for Female BOO

Clinical Interpretation

PIP1: -- fBOOi: -- Void%: -- Contractility: -- Confidence: --

Status

Post-MUS Sub-Analysis (Zimmern et al. Model)

Treatment Prognosis:

Mentor's Note & Clinical Context

Academic References & Source Articles

Solomon E, Yasmin H, Duffy M, Rashid T, Akinluyi E, Greenwell TJ. (2018). Developing and validating a new nomogram for diagnosing bladder outlet obstruction in women. Neurourology and Urodynamics, 37(1), 368-378. [DOI ↗]
Rosier PFWM, Valdevenito JP, et al. (2023). ICS-SUFU standard: Theory, terms, and recommendations for pressure-flow studies performance, analysis, and reporting. Continence.
Castro-Nuñez P, Moreno-Palacios J, et al. (2022). Solomon-Greenwell as the most accurate nomogram for female bladder outlet obstruction. Revista Mexicana de Urología.
Bass Z, Christie AL, Zimmern PE. (2024). Validation of nomogram for probability of bladder outlet obstruction in women with obstructive symptoms after mid-urethral sling. The Journal of Urology.

Medical Disclaimer & Waiver of Liability

Clinical Decision-Support Tool Only (BETA Version): This software, including its automated calculations (PIP1, fBOOi, Post-MUS BOO probability), nomograms, and generated interpretations, is designed purely as an educational and clinical decision-support tool for use by qualified healthcare professionals. It does not constitute formal medical advice, diagnosis, or treatment recommendations.

Clinician Responsibility & Waiver of Liability: Automated outputs do not substitute for independent professional clinical judgment, full patient history, or clinical assessment. The treating physician or medical professional retains sole and absolute responsibility for all diagnostic, medical, and surgical decisions, as well as patient outcomes.

Data Privacy: Do not input Protected Health Information (PHI) or Personally Identifiable Information (PII) into this application. All data processing occurs locally within the user's browser environment.